Assessment of recurrence and complications following uncomplicated diverticulitis

作者：Buchs N C; Konrad Mugnier B; Jannot A S; Poletti P A; Ambrosetti P; Gervaz P^*

来源：British Journal of Surgery, 2013, 100(7): 976-979.

DOI：10.1002/bjs.9119

Background: The natural history of sigmoid diverticulitis has been inferred from population-based or retrospective studies. This study assessed the risk of a recurrent attack following the first episode of uncomplicated diverticulitis.
Methods: Patients admitted between January 2007 and December 2011 with a first episode of uncomplicated sigmoid diverticulitis confirmed on computed tomography were enrolled in this prospective study. After successful medical management of the first episode, follow-up was conducted through yearly telephone interviews. Cox proportional hazards regression was performed to model the impact of various parameters on eventual recurrences and complications.
Results: During a median follow-up of 24 (range 3-63) months, 46 (16.4 per cent) of 280 patients experienced a second episode of diverticulitis. Six patients (2.1 per cent) subsequently developed complicated diverticulitis and four (1.4 per cent) underwent emergency surgery for peritonitis. In multivariable analysis, a raised serum level of C-reactive protein (over 240 mg/l) during the first attack was associated with early recurrence (hazard ratio 1.75, 95 per cent confidence interval 1.04 to 2.94; P = 0.035).
Conclusion: Uncomplicated sigmoid diverticulitis follows a benign course with few recurrences and little need for emergency surgery. Registration number: NCT01015378 (http://www.clinicaltrials.gov).

• 出版日期2013-6